Health Literacy Resources Refresher

Posted by Emily Glenn on February 19th, 2015 Posted in: Public Health

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Adequate health literacy is essential to health care, public health, and the way our society views health. Improving the health literacy of the population has been broadly recognized as an important goal and is one of the major objectives in the Healthy People 2020 Health Communication and Health Information Technology topic.   Health literacy is not just about reading — it requires a complex group of reading, listening, analytical, and decision-making skills, and the ability to apply these skills to health situations. For example, it includes the ability to understand instructions on prescription drug bottles, appointment slips, medical education brochures, doctor’s directions and consent forms, and the ability to negotiate complex health care systems.

Consumers rely heavily on the health information that is available to them, yet about 9 out of 10 American adults have some problems with health literacy. The National Assessment of Adult Literacy (NAAL) report, The Health Literacy of America’s Adults: Results From the 2003 National Assessment of Adult Literacy, provides information on the status of the health literacy of American adults age 16 and older and shows that socioeconomic factors are linked to health literacy. NAAL reports that low health literacy is higher among adults who spoke a language other than English before starting school and among individuals who did not complete high school. More than 76% of respondents in the survey who did not complete high school scored at the “Below Basic” or “Basic” level of health literacy.  NAAL also reported a relationship between health literacy and race or ethnicity: white respondents scored better on the survey than other ethnic or racial groups. Only 9% of White respondents scored at the lowest (“Below Basic”) level. However, 24% of Blacks, 41% of Hispanics, 13% of Asians, and 25% of American Indian and Native Alaskan respondents scored at the “Below Basic” level. In addition, 30% of adults who receive Medicaid were found to have “Below Basic” health literacy. Living below the poverty level or having chronic mental or physical health conditions put people at risk for low health literacy.

People with low health literacy use more health care services, have a greater risk for hospitalization, and have a higher utilization of expensive services, such as emergency care and inpatient admissions. (IOM, 2004) However, health literacy–especially when combined with a focus on prevention and integrative health–is one of the most promising approaches to advancing public health (Pleasant, 2014). The National Network of Libraries of Medicine (NNLM) recognizes these overarching issues and supports health literacy education on its robust and popular Health Literacy page. Below is a selection of relevant and freely available resources for practitioners, educators, and others who are in a position to manage communications and outreach or develop programs to improve literacy.

The AHRQ Health Literacy Universal Precautions Toolkit, 2nd edition, can help primary care practices reduce the complexity of health care, increase patient understanding of health information, and enhance support for patients of all health literacy levels. Presentations include a “shadow” visit to a doctor’s office and a presentation packed with practical strategies that can help practices do a better job caring for people with low health literacy. Questions to Ask Your Doctor helps people prepare to communicate with their health care providers before, during and after appointments. The “Health Literacy: Hidden Barriers and Practical Strategies” presentation describes health literacy research, like the “Show Me How Many Pills You Would Take in 1 Day” image in the screenshot below.

Understanding Medical Words: A Tutorial from the National Library of Medicine is a game-like interactive tutorial that teaches how to put together parts of medical words and provides basic patient-provider scenarios for learning. A slide showing one of the word matching exercises is above. The tutorial can also be downloaded.

Promoting Health Literacy with Free Information & Cool Tools from your National Library of Medicine is a three-part video training series (facilitator guide included) designed for social and health services providers and programs with limited time and money for training and materials. The brief videos (8-10 minutes) focus on evidence-based information resources and empowering patients and families to use them, developing reflective health literacy skills needed to use information for health, and empower a person to use information for health. This includes a role-played health story.

The CDC offers five online health literacy courses for health professionals covering writing, speaking, communicating visually, explaining risk and using numbers. Good Questions for Good Health toolkit, a consumer and patient communication skill-building module, encourages question-asking and provides strategies for formulating and asking questions before, during, and after medical appointments. The Toolkit includes a presentation, presentation notes, skill building activity, take-home handout, and an evaluation form.

The Northwest Regional Primary Care Association, a member of the NNLM/PNR, also provides guides to several resources on their Health Literacy page.

This article was originally published in a slightly different version in the February 2015 issue of QuickNotes, the newsletter of the Northwest Regional Primary Care Association.